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Sports Science Exchange (2014) Vol. 27, No. 135, 1-6

MONITORING FATIGUE AND RECOVERY

Shona L. Halson  | Recovery Center | Australian Institute of Sport | Canberra | Australia

KEY POINTS
• Appropriate load monitoring can aid in determining if an athlete is adapting to a training program and to minimize the risk of developing non-
functional overreaching (fatigue lasting weeks to months), illness and/or injury.
• Research has investigated a number of external load quantifying and monitoring tools, such as power output measuring devices, time-motion
analysis, as well as internal load unit measures, including perception of effort, heart rate, lactate concentration and training impulse. Dissociation
between external and internal load units may reveal the state of fatigue of an athlete.
• Heart-rate recovery, neuromuscular function, biochemical/hormonal/immunological assessments, questionnaires and diaries, psychomotor
speed and sleep quality and quantity are other monitoring tools utilized by high-performance programs.
• The monitoring approach taken with athletes may depend on whether the athlete is engaging in individual or team sport activities, but the
importance of individualization of load monitoring cannot be overemphasized.
• Detecting meaningful changes with scientific and statistical approaches can provide confidence and certainty when implementing change.
• Appropriate monitoring of training load can provide important information to athletes and coaches; however, monitoring systems should be
intuitive, provide efficient data analysis and interpretation, and enable efficient reporting of simple, yet scientifically valid feedback.

INTRODUCTION MONITORING LOAD

As athletes strive to improve their performance, modifications in
training load are required, and in particular, increases in frequency,
duration and intensity. Training loads are managed at various times
during the training cycle to either increase or decrease fatigue
depending on the phase of training (i.e., baseline or competition
phase). Ensuring that fatigue is adjusted appropriately is critical for
both adaptations to training as well as competition performance.
To monitor is often defined as “observing and checking the
progress or quality of something over a period of time” (Oxford
English Dictionary Online). When considering a specific definition of
monitoring for athletes, confusion may arise based on single, one-off
assessments (i.e., a yearly nutrition assessment) vs. more frequent
routine monitoring. For the purpose of this article an assessment
of an athlete will be considered monitoring if, 1) the assessment
occurs more than once and 2) the assessments occur with enough
frequency to give the desired and relevant information to the athlete,
coach or scientist.
Monitoring the training load of an athlete is viewed by many as
important to determine if an athlete is adapting to the training program
and to minimize the risk of non-functional overreaching (fatigue
lasting weeks to months), injury and illness (Halson & Jeukendrup,
2004). To date, research in this area is limited and much of what
we know about monitoring comes from personal experience and
anecdotal information.
Reasons for and Against Monitoring Load
As mentioned above, there are a number of reasons why monitoring
training load is becoming an increasingly modern, scientific approach
to understanding athletes, training responses and competition
readiness. Although published data on high-level athletes is lacking,
monitoring training load can provide an explanation for changes in
performance if performed using scientific principles. This can aid in
enhancing the clarity and confidence regarding possible reasons for
changes in performance and to minimize the degree of uncertainty
associated with the changes. From this data, it is not only possible
to retrospectively examine load-performance relationships, but also
enable appropriate planning for training loads and competitions.
Importantly, load monitoring is also implemented to try to reduce the
risk of injury, illness and non-functional overreaching. Data may also
be useful for team selection and determining which athletes are ready
for the demands of competition.
There are also a number of benefits related to communication and
relationship building with athletes, support staff and coaches. When
athletes are involved in monitoring, it can enhance their feeling of
involvement in the training program and they feel both empowered as
well as having a sense of ownership. Data collected from monitoring
training can also be useful to facilitate communication between the
support staff and coaching staff. When combined, these benefits can
help enhance the belief associated with the training program.

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However, not all coaches and scientists engage in athlete monitoring. Table 1: Variables that can be used to monitor training load and subsequent
For some athletes/teams, insufficient resources can be a major fatigue. RPE - Rating of Perceived Exertion; REST-Q - Recovery Stress
reason for not including a system of training monitoring. Resources Questionnaire; VAS - Visual Analogue Scale.
may be in the form of time, money or the human resources needed VARIABLE UNITS/DESCRIPTORS
to collect, process and analyse the data. Further, since there are
Frequency Sessions per Day, Week, Month
no guarantees that monitoring training load will result in successful
performances, resources may be withheld. A lack of knowledge Time Seconds, Minutes, Hours
or experience with monitoring techniques can also result in an Intensity Absolute, Relative
inability to implement a practical and sustainable system and/or an Type Modality, Environment
inability to interpret the data collected. In addition, a clear rationale Maximal Effort Max Mean Power, Jump Height
identifying why the monitoring is occurring, what will be monitored, Repeat Efforts Number of Efforts, Quality of
how often monitoring will occur and how the data will be interpreted Efforts
and presented back to the coaching staff is required. Finally, the
Training Volume Time, Intensity
ability and opportunity to implement change and provide feedback is
critical to a successful monitoring system, and if this does not occur, Perception of Effort RPE
many attempts at monitoring are not sustainable. Perception of Fatigue and Questionnaires; REST-Q, VAS
Recovery
Potential Load Monitoring Measures Illness Incidence, Duration
In order to gain an understanding of the training load and its effect on Injury Type, Duration
the athlete, a number of potential markers are available to athletes,
Biochemistry and Hormone Baseline, Response to Exercise
coaches and scientists. However, very few of these markers have
Analysis
strong scientific evidence supporting their use and there is yet to
Technique Movement Deviations
be a single, definitive marker described in the literature. To assess
fatigue, it would appear that the best test in terms of ecological Body Composition Total Body Weight, Fat Mass,
validity would be a maximal performance test replicating the Fat-Free Mass
athlete’s event/competition. However, there are numerous difficulties Sleep Quality, Quantity, Routine
regarding maximal testing in athletes. Maximal tests may add to Psychology Stress, Anxiety, Motivation
existing fatigue in an athlete, which may be problematic around Sensations Hopeful, Neutral, Hopeless
competition phases. A taper may also be required to determine true
performance capabilities, which is often impractical. Athletes may monitoring. Indeed, it may be the relationship between external
also lack motivation when fatigued to produce a maximal effort that and internal loads that help in revealing fatigue. For example, using
is not for competitive purposes. For many sports, in particular team the cycling external load mentioned above, the power output may
sports, it is also extremely difficult to replicate or even define maximal be maintained for the same duration; however, depending on the
performance (Taylor, 2012). Finally, if maximal performance only is fatigue state of the athlete, this may be achieved with a high or low
assessed, little information can be gained regarding the potential heart rate or a high or low perception of effort. It is this uncoupling
mechanism(s) of fatigue. Table 1 outlines a number of variables that or divergence of external and internal loads that may differentiate
can be used to monitor training load and the resultant fatigue. between a fresh and a fatigued athlete (Pyne & Martin, 2011).

Internal Versus External Load METHODS OF MONITORING EXTERNAL LOAD

When monitoring training load, the load units can be thought of as
either external or internal. Traditionally, external load has been the
foundation of most monitoring systems. External load is defined as
the work completed by the athlete measured independently of his
or her internal characteristics (Wallace et al., 2009). An example of
external load in road cycling would be the power output achieved
for a given duration of time (e.g., 400 W for 30 min). While external
load is important in understanding work completed and capabilities
and capacities of the athlete, the internal load, or the relative
physiological and psychological stress imposed, is also critical in
determining the training load and subsequent adaptation. As both
external and internal loads have merit for understanding the athlete’s
training load, a combination of both may be important for training
To gain an understanding of external training load, there are a
number of technologies available to athletes and coaches. In the
sport of cycling, power output measuring devices such as SRM™
and PowerTap™ allow the continuous measurement of work rate
(power output) (Jobsen et al., 2009). Training and competition can
be recorded and data can be analysed to provide information on a
number of parameters including average power, normalised power,
speed and accelerations. Cycling power output can be converted
into a Training Stress Score™ (TSS™) via commercially available
software (Pyne & Martin, 2011) and allows the quantification of
training based on relative intensity, duration and frequency.

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In team sports, time-motion analysis (TMA), including global
positioning system (GPS) tracking and movement pattern analysis
via digital video (such as ProZone™) are becoming increasingly
popular to monitor athletes (Taylor, 2012), particularly during
competitions. Typically, when using TMA for monitoring, arbitrary
speed thresholds are set (Lovell & Abt, 2013). These categories
may include walking, jogging, running, striding, sprinting, etc.
(Aughey, 2011). The reliability of GPS for monitoring movement is
influenced by factors such as sample rate, velocity, duration of task
and the type of task (Aughey, 2011). From the available literature, it
appears that the higher the velocity of movement, the lower the GPS
reliability (Aughey, 2011). Further, the reliability is also reduced when
assessing tasks that require changes of direction and GPS does
not quantify the load of jumping, kicking a ball and tackling actions
(Aughey, 2011).
Neuromuscular Function
Measures of neuromuscular function such as jump tests
(countermovement/squat jump), sprint performance and isokinetic
and isoinertial dynamometry are often utilized in the team sport
environment (Twist & Highton, 2013). These assessments have
become popular due to the simplicity of administration and the
minimal amount of additional fatigue induced. Common variables
from jump test measurements include mean power, peak velocity,
peak force, jump height, flight time, contact time and rate of force
development (Taylor, 2012; Twist & Highton, 2013).
METHODS OF MONITORING INTERNAL LOAD
Perception of Effort
The rating of perceived exertion (RPE) is one of the most common
means of assessing internal load. The use of RPE is based on the
notion that athletes can monitor their physiological stress during
exercise as well as retrospectively provide information regarding their
perceived effort post training or competition. Evidence suggests that
RPE correlates well with heart rate during steady-state exercise and
high-intensity interval cycling training, but not as well during short-
duration high-intensity soccer drills (Borresen & Lambert, 2009).
Further, a meta-analysis of the literature reported that while RPE is a
valid means of assessing exercise intensity, the validity may not be
as high as previously thought (Chen et al., 2002).
Session RPE
Foster (1998) developed the Session RPE method of quantifying
training load and it involves multiplying the athlete’s RPE (on a 1-10
scale) by the duration of the session (in min). This simple method has
been shown in the literature to be valid and reliable (Foster, 1998).
While the session RPE method may be simple, valid and reliable, the
addition of heart rate monitoring may aid in understanding some of
the variance not explained by the session RPE method.
Heart Rate
Monitoring heart rate is one of the most common means of assessing
Sports Science Exchange (2014) Vol. 27, No. 135, 1-6
internal load in athletes. The use of heart rate monitoring during
exercise is based on the linear relationship between heart rate and
oxygen uptake and the intensity of steady-state exercise (Hopkins,
1991); however, the percentage of maximum heart rate is often used
to both prescribe and monitor intensity (Borresen & Lambert, 2008).
Due to the daily variation in heart rate (up to 6.5%), controlling for
factors such as hydration, environment and medication is important
(Bagger et al., 2003). Heart rate measurements in isolation may have
limited value, but combined with other measurements can become
more powerful (Achten & Jeukendrup, 2003).
Heart Rate-Perception of Effort Ratio
The examination of physiological and perceptual indicators of load,
at a fixed submaximal intensity, can provide information on the
state of fatigue in the athlete. The combination of heart rate and
perception of effort measures (HR-RPE ratio) may aid in elucidating
fatigue (Martin & Andersen, 2000). For example, the internal load of
a cyclist who has a reduced submaximal heart rate in combination
with an elevated perception of effort may be quite different from a
cyclist with a normal HR-RPE ratio (Pyne & Martin, 2011).
Training Impulse (TRIMP)
The training impulse (TRIMP) is often considered a useful means of
assessing training load (Pyne & Martin, 2011) and is a unit of physical
effort that is calculated using training duration, maximal heart rate,
resting heart rate and average heart rate during the exercise session
(Morton et al., 1990). Further derivations of Banister’s initial TRIMP
model have been developed. These include Edwards’ TRIMP, which
uses accumulated time in five arbitrary heart rate zones multiplied
by a weighting factor (Edwards, 1993). Lucia’s TRIMP model is
similar to the Edwards derivation; however, there are three heart rate
zones which are based on individually determined lactate thresholds
and onset of blood lactate accumulation (Lucia et al., 2000). Further,
the use of an individualised TRIMP (iTRIMP) has been developed
for use in runners (Manzi et al., 2009) and recently tested in soccer
players (Akubat et al., 2012). The use of the iTRIMP reduces issues
associated with arbitrary zones and generic weightings.
Lactate Concentrations
Blood lactate concentrations are sensitive to changes in exercise
intensity and duration (Beneke et al., 2011). However, there are a
number of potential limitations to the use of regular monitoring of
lactate concentrations during training and competition. These
include inter- and intra-individual differences in lactate accumulation
and differences in lactate accumulation depending on ambient
temperature, hydration status, glycogen content, previous exercise,
the amount of muscle mass utilized and sampling procedures (time
and site) (Borresen & Lambert, 2008).
Lactate-Perception of Effort Ratio
Similar to the HR-RPE ratio, the lactate to RPE ratio may be useful
in determining internal load and identifying fatigue in athletes
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(Snyder et al., 1993). Again, changes in these parameters at a fixed
submaximal workload may be useful to identify physiological and
perceptual changes in internal load.
Heart-Rate Recovery (HRR)
Heart-rate recovery (HRR) is the rate at which the heart rate declines
at the cessation of exercise and has been suggested to be a marker
of autonomic function and training status in athletes (Daanen et al.,
2012). HRR can be calculated over varying time frames, usually
between 30 s to 2 min, with the difference between the end of
exercise heart rate and heart rate at 60 s post exercise being most
commonly used.
In a recent review on HRR and monitoring changes in training status,
it was suggested that HRR improves with increased training status,
remains unchanged when there is no change in training status and
decreases when training status is reduced (Daanen et al., 2012).
It was then concluded that with the exception of overreaching
(where research is conflicting), HRR could be used to monitor the
accumulation of fatigue in athletes. However, the considerations
mentioned above regarding standardisation of factors that may
influence heart rate, are also relevant for HRR.
Biochemical/Hormonal/Immunological Assessments
Some research has been conducted examining a range of
biochemical, hormonal and immunological responses to exercise,
primarily in a bid to monitor fatigue and minimize excessive fatigue
and illness. It is beyond the scope of this article to review the literature
in this area; however, in short, the use of biochemical, hormonal and/
or immunological measures as indicators of internal load is currently
not justified based on the limited research in this area. In addition,
these measures can be costly, time consuming and not practical in
an applied environment (Shetler et al., 2001).
Questionnaires and Diaries
Questionnaires and diaries can be a relatively simple and
inexpensive means of determining the training load and subsequent
responses to training. However, both questionnaires and diaries rely
on subjective information, which may need to be corroborated with
physiological data (Borresen & Lambert, 2009). It is possible for
athletes to manipulate data and/or over- or under-estimate training
load. Importantly, the frequency of questionnaire administration
and length of questionnaire should be considered to maximize
compliance and avoid questionnaire “fatigue”. There are a number of
questionnaires identified in the literature which have been utilised by
high-performance sport programs (Taylor, 2012). These include the
Profile of Mood States (POMS) (Morgan et al., 1987), The Recovery-
Stress Questionnaire for Athletes (REST-Q-Sport) (Kellmann &
Kallus, 2000), Daily Analysis of Life Demands for Athletes (DALDA)
(Rushall, 1990) and the Total Recovery Scale (TQR) (Kentta &
Hassmen, 1998).
Sports Science Exchange (2014) Vol. 27, No. 135, 1-6
While questionnaires can provide simple and often useful subjective
information, factors such as frequency of administration, time taken
to complete the question, sensitivity of the questionnaire, type of
response required (written answers or circling responses), time of
day of completion and the amount of time required for appropriate
feedback, should be considered.
Sleep
Sleep loss or deprivation can have significant effects on
performance, motivation, perception of effort and cognition as well
as numerous other biological functions. Monitoring sleep quality and
quantity can be useful for early detection and intervention before
significant performance and health decrements are observed.
The use of simple diaries indicating hours of sleep and perceived
sleep quality can be useful. Other non-invasive methods such as
actigraphy (wrist watch device utilizing accelerometry) can provide
more detailed information over shorter periods (7-14 d). Actigraphy
can provide data on bedtime, wake time, sleep onset latency (time
taken to fall asleep), wake during sleep, sleep efficiency (estimate
of sleep quality), as well as provide information on sleep routines.
Due to the increasing knowledge regarding the importance of sleep,
monitoring and assessment of sleep is becoming popular with elite
athletes, coaches and support staff (Halson, 2014).
TEAM SPORTS VERSUS INDIVIDUAL SPORT ATHLETES
The nature of load monitoring required, or indeed possible, may vary
greatly between team sport and individual sport athletes. Monitoring
in team sports is often perceived to be more challenging due to
the diverse range of training activities (e.g., general conditioning,
resistance training, interval training and skill-based conditioning)
commonly employed. Further, the assessment of skilled performance
and “cognitive load” or fatigue that influences decision-making is
important for team sport performance and poses many challenges
for accurate assessment.
When monitoring team sport athletes, some of the most useful
measures involve physiological changes, assessment of movement
patterns and indicators of skills, with these measures being as sport
specific as possible (Pyne & Martin, 2011). Movement patterns
can be assessed by time-motion analysis or GPS tracking. Other
difficulties when assessing team sport competition performance
include the influence of team tactics (including the opposing team),
environmental conditions, team cohesion, home or away competition
and travel.
In individual sports such as cycling, swimming and triathlon, the
fatigue is often the result of high training loads, and the management
of these loads through monitoring can be particularly important
(Pyne & Martin, 2011). Load monitoring is often based on training
volume, duration and intensity alongside indicators of perceptual
fatigue such as RPE.
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UTILIZING A SYSTEMS-BASED APPROACH
With the increasing amounts of data available from monitoring
devices such as GPS, digital video, SRM devices, in combination
with internal load measurements such as heart rate, questionnaires
and perceptions of fatigue, comes the requirement to incorporate
this information into a database and data management system that
results in efficient access to meaningful information. According to
Pyne & Martin (2011), “a systems-based approach that integrates
well-chosen diagnostic tests, with smart sensor technology, and
a real-time database and data management system, is the future
for fatigue management in elite sport.” There are now a number of
commercially available athlete monitoring systems such as Training
Peaks™, Kinetic Athlete and Smartabase, which allow for integration
of data and simple reporting tools that are becoming increasingly
popular in high-performance sport.
KEY FEATURES OF A SUSTAINABLE MONITORING
SYSTEM
An effective and sustainable monitoring system is critical
to ensure that data are effectively captured and reported.
Table 2 identifies several key features of such a system.
Table 2. Key Features of a Sustainable Monitoring System.
Ease of use/intuitive design
Efficient result reporting
Can be used with or without Internet connection, i.e., able to be
utilized effectively remotely
Data should be able to be translated into simple outcomes, such
as effect sizes
The system should be flexible and adaptable for different sports
and athletes
Identification of a meaningful change should be simple and
efficient
Should include an assessment of cognitive function
Be able to provide both individual responses and group
responses
PRACTICAL APPLICATIONS
• Monitoring tools should be sport specific and more than one tool
may be used to ensure accurate information is provided.
• Monitoring should occur frequently enough to provide the
necessary information; however, not so often that compliance is
reduced. Weekly measurements are common in high-performance
programs.
• The feedback provided to coaches and athletes should be given
as soon as possible after data collection, be easy to interpret and
include simple indicators of whether any change in measures are
meaningful and/or whether an intervention is required.
• Monitoring should be sustainable from a financial and human
resource perspective, be a simple addition to the training program
and take minimal time for the athlete to complete.
Sports Science Exchange (2014) Vol. 27, No. 135, 1-6
CONCLUSION
Utilizing scientific principles for load monitoring can be an important
means of reducing the risk of non-functional overreaching, illness
and injury. With many athletes exposed to high training loads and
high training and competition stress, it is necessary to manage risks
associated with the possible negative outcomes and to maintain
optimal physiological and psychological health and well-being of
the athlete. While a range of potential measures of external and
internal load have been described, numerous factors are involved in
determining the reasons for and against load monitoring, the specific
type of monitoring necessary for the sport and the individual and
ensuring change is evaluated in an appropriate manner. If accurate
and easy to interpret feedback is provided to the athlete and coach,
load monitoring can result in enhanced knowledge of training
responses, aid in the design of training programs, provide a further
avenue for communication between support staff and athletes
and coaches and ultimately enhance an athlete’s performance.
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